T Nation

Need Help in South Korea, Starting TRT

Hey guys I’m 36 and an ex professional athlete I’m very active but recently had an accident off the field that caused me to have 14 surgeries and lots of meds that completely knocked my testosterone out.After 2 years of surgeries my testosterone was 2.55 nd/ml.I’m American but living in South Korea right now for work.so doctor here started me on testosterone enanthate.250 injection every week to week and a half.my testosterone has went up to 8.59 but still don’t feel the best not sure what more questions I need to find out.Or if they are doing everything right.


I uploaded picture of last blood test so any help would be appreciated especially since I’m in foreign country thanks

What’s free test looking like? SHBG? Estradiol? Thyroid labs? You need more testing…

Is sustanon the only option available over there?

Total T in the absence of Free T measurements and no SHBG testing and nothing is certain.

Total T is the hormone that is bound to SHBG, it is not bioavailable, the Free T is what matters and can be calculated using Total T and SHBG if no Free T testing is available. If SHBG is low weekly injections is not appropriate, more frequent smaller injections is usually needed especially if estrogen is high.

No estrogen testing either, Free T is converted to estrogen and needs testing in order to guide your protocol decisions. Without Free T, estrogen or SHBG, you are lost. Labs are drawn 6 weeks after starting TRT or protocol changes as it takes the body 6 weeks to adapt and for the half life to build up in your system.

You’re not expected to feel amazing right away, TRT is not like party drugs where the effect is instant, it takes time for your body to actually use testosterone once sufficiently elevated. How long this takes will be determined by androgen receptor sensitivity, most take 6-12 months to reach maximum benefit.

I’m 6’3 250lbs and have gone through one cycle and am on the second shot of second cycle as the doctor said he recommends two rounds because my testosterone was so low.

I asked about the free testosterone and everything from getting on this site and finding out everything that’s important and the doctor is going to get back to me.i will probably need to get another blood test because I’m not sure they tested for all that over here.my thyroid is fine.prostate is good.blood is not thick.so I need to check estrogen levels and free testosterone is there any other advice as I’m pretty much on my own and my translator isn’t very knowledgeable on translating my questions so communicating these things has been difficult but I just want to make sure they are getting me where I need to be thanks again and god bless

You don’t cycle TRT, TRT is for life and you don’t ever come off because the moment you come off your levels will return to baseline and you’ll have low T again.

Cycling TRT is something you do when you have normal testosterone levels and you want a little extra boost so you cycle TRT to preserve your natural optimal levels.

You’re levels are permanently low because of all your surgeries, you will need TRT for life, therefore you don’t cycle TRT.

It sounds like your doctor doesn’t understand things very well and isn’t even getting lab testing correct. I’m sorry to say but your doctor is a quack, he doesn’t have a basic understanding of what he’s doing.

Some doctors are borrowing knowledge from the bodybuilding world because they don’t know anything else because they didn’t go to the medical school for training.

You are suppressing your natural production when you are on Test. It will stay essentially at zero for at least a few weeks after your last shot, more likely for a few months. What you are taking is not supplementing your natural production it replaces it. It will not provide you with any sort of positive boost that continues past the use. We don’t know enough about your other medical issues and their effects on you to offer much advice. What is your Total T on shot day before the shot? What else are you taking? Pain meds?

Okay so 2015 I broke my leg and when doctors put in rod it got infected so after 5 surgeries I changed doctors and they said rod had to be removed or I was gonna lose my leg if I didn’t already. I was on tons of antibiotics and pain meds.vancomycin was the antibiotic through a pic line into my heart 3 times a day I gave myself this.morphine and OxyContin was pain meds 30 mg 12 hour time release with morphine 2 a day and 20 mg oxy 7 times a day.this crushed my testosterone and I was at 80 for testosterone.since I needed to have an inch of dead bone removed and I had to regrow the bone they were cutting out with a lozarov frame and testosterone has affect on bone growth my doctor got me to see specialist who put me on testosterone gel at first which did nothing.With having children I hated having to worry about touching them or getting it on them so he switched me to cypionate injections 250 every week after 9 more surgeries I grew back the bone and was off all antibiotics and meds this was 2017 .I stayed on testosterone and I moved to Alabama from pennsylvania and had to get new doctor who told me I was to young for trt and took me off injections even knowing everything I been through .I felt horrible for two weeks he then put me on clomiphene and then eventually weened me off of that.So long story short I got off everything because I was trying to get back to professional ball which I did and obviously you can’t be on steroids to play.i spent 2018 rehabbing from 2 years of being bed ridden and played winter ball in October 2018.then I got coaching job offer so decided at my age that it was best for me and my family to take job .I then decided to get my blood tested again because I was always tired and depressed and my natural level was 220 to I saw a doctor where I’m at in Korea and he started me on injections after 6 weeks my levels were 836 but this is testosterone enanthante still 250 mg every 10 days I take vitamin d3 10,000 iu vitamin c 1000 mg and that’s pretty much it I don’t drink or smoke or take drugs and I really appreciate any and all advice as I said I’m in South Korea now so I’m just trying to make sure I can tell doctors what they need to test and do for me.if you need any more details I will reply with exactly what you need thanks again

Those pain meds lower testosterone, especially oxycontin. Most doctors still believe TRT causes prostate cancer and why doctors are afraid to put young men on TRT opening themselves up to lawsuits if you should get prostate cancer ruining their career.

If doctors put an older 50 year old man on TRT and he gets prostate cancer, well this is common at this age and it cannot be blamed on the TRT, so the doctor is in the clear and cannot be sued.

The funny thing is TRT doesn’t cause prostate cancer, it was based off unproven testing methods in 1941 and was based off anecdotal evidence which scare western medicine.

Your doctor doesn’t care about you, he cares about his career, it’s self preservation. You need to find a compassionate doctor who knows hormones, not a doctor who has been mislead.

Read the post, he’s not on any of that now but is taking Enanthate from his doc.

Enanthate has a 7 day half-life, more or less. You should be taking your shot at least every seven days. The same dose for a weekly shot would be 150mg per shot. That all by itself would make a difference.

I know he’s not on oxycontin, I was only informing him as to why his testosterone is low in the first place.

It was 80 while on oxy I have been off everything for more then a year and it was 220 it’s almost like it never recovered fully from all the stress my body was put through during those 2 years

I’m going Monday to talk to doctor they are going to take another more in depth blood test.I told them I need to know my free t and estrogen levels is there anything else I should have them test for?Is there anyway to not eliminate my production and just supplement it with injections?right now I understand that my production is basically being put on pause because I’m taking injections.I’m just worried about it because I’m in South Korea know and doctors pretty willing to get me right just hard communicating but everything I’ve told him from this forum, he agrees with and is gonna get me right ,but when I leave here to go back to America finding a doctor willing to keep me where I need to be might take time and might not be covered by insurance etc. I will most likely be over here at least one more year.

Similar story, was on Klonopin for 30 years, was perfectly alright until I started tapering, Total T dropped to 97-119 ng/dL and stayed there. Over the years I have seen many who were on pain meds who also have similar stories.

The guys on pain meds seem to have the lowest Total T of anyone on T-Nation, it’s a trend.

The insurance part is easy, finding a knowledgeable doctor that specializes in TRT, good luck.

You need to seek a private doctor that prescribes TRT on a daily basis, these doctors figure shit out quick, the doctors that prescribe it less often seem to be the most clueless and follow dated guidelines.

Some guys do well on weekly, most do well on two or more injections per week.

Just went Monday and got another blood test they are testing SHBG ,estrogen,free t and total t
My injections right now are 250 mg every 2 weeks I’ve had 8 injections so far I will let you know results if you could give me any more advice thanks

You have cypionate, my clinical literature says its half life is ~5d.

You will not feel well ever injecting every 2 weeks, inject every 1-3 days unless high shbg. With high shbg you can inject less frequently.

I break my 1ml Susta ampuls and put the testosterone in a 10ml vial and inject EOD. You should buy a vial and draw from there or draw the syringes for future straight after breaking your ampuls.

Cyp E14D is no good trt! Put your E14D protocol in steroidcalc and see for yourself – hormones all over like a monthly menstruating woman!

This isn’t going to work, a 2005 clinical study was already done and the results are linked below, pay attention to figure 1 graph B, before the week has ended levels are below the therapeutic ranges while leaving estrogen high creating estrogen dominance.

Male patients injected with 200mg enanthate every 2 weeks

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New blood test one week after 8th injection of 250 enanthante